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Compare Zepbound vs. Contrave

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Tirzepatide (Zepbound) and naltrexone / bupropion (Contrave) are both medications used to help with weight loss in adults. However, they belong to different medication classes and have distinct mechanisms of action. Tirzepatide is a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, administered as a weekly subcutaneous injection. It's also approved for treating moderate-to-severe sleep apnea. In contrast, Contrave combines an opioid antagonist (naltrexone) and a dopamine and norepinephrine reuptake inhibitor (bupropion) and is taken orally as tablets twice daily. While both medications can cause nausea, tirzepatide may lead to side effects like diarrhea and injection site reactions, whereas Contrave can cause headaches and insomnia. Tirzepatide has potential interactions with diabetes medications, warfarin (Jantoven, Coumadin), and birth control pills, while Contrave should not be taken with opioids or certain other medications due to the risk of opioid withdrawal, seizures, and other serious side effects. Both medications are only available in brand-name forms.

Zepbound (tirzepatide)
Contrave (naltrexone / bupropion)
Zepbound (tirzepatide)
Contrave (naltrexone / bupropion)
Summary of Zepbound vs. Contrave
Summary for GIP and GLP-1 agonist
Prescription only
Zepbound (tirzepatide) is an injectable medication that's used along with diet and exercise. It helps with weight loss in adults who meet criteria for weight management therapy. It's also approved to treat moderate-to-severe sleep apnea. This medication belongs to the drug class called GIP and GLP-1 agonists. The dosage is 1 injection under the skin once a week. Common side effects include nausea, diarrhea, and injection site reactions. Zepbound (tirzepatide) is only available as a brand-name medication.
Summary for Opioid antagonist / Dopamine and norepinephrine reuptake inhibitor
Prescription only
Contrave is a combination medication that helps with weight loss for certain adults. It's taken along with a balanced diet and exercise plan. Contrave is a tablet with two active ingredients that help regulate your appetite. They are naltrexone (an opioid antagonist) and bupropion (a dopamine and norepinephrine reuptake inhibitor). Your dosage will slowly increase over the first 3 weeks. Then, you take the maintenance dose of two tablets by mouth twice a day. Some side effects are nausea, constipation, and headache. But it can also have serious risks, like unusual changes in behavior. Contrave is brand name only; there isn't a generic version available yet.
Indications of Zepbound vs. Contrave
Indications for
In addition to a balanced diet and exercise plan:

•Weight loss and long-term weight management in adults considered obese or overweight with at least one weight-related condition (e.g., high blood pressure, Type 2 diabetes)

•Moderate-to-severe obstructive sleep apnea (OSA) in adults considered obese

Indications for

•Long-term weight management in certain adults

•Adults with a body mass index (BMI) of 30 kg/m2 or greater

•Adults with a BMI of 27 kg/m2 or greater and a weight-related condition (e.g., high blood pressure, Type 2 diabetes, high cholesterol)
Pros and Cons of Zepbound vs. Contrave
Pros and Const for GIP and GLP-1 agonist
Pros

•Injected once a week

•Can take with or without food

•Different strengths available, so it's adjustable depending on your needs

Cons

•Must be injected under the skin

•Can cause bothersome side effects, like nausea, diarrhea, and stomach pain

•Can't use with other tirzepatide products (Mounjaro) or with other GLP-1 agonists

Pros and Const for Opioid antagonist / Dopamine and norepinephrine reuptake inhibitor
Pros

•Comes as a tablet that you take by mouth

•Might start to notice results in as early as 4 weeks (when taken along with a balanced diet and regular exercise)

Cons

•Must take twice a day (after the dose ramp-up at the beginning)

•Might raise your risk of unusual behavior and thoughts of self-harm

•Interacts with a lot of medications
Common Side Effects of Zepbound vs. Contrave
Common Side Effects for

•Nausea (25-29%)

•Diarrhea (19-23%)

•Constipation (11-17%)

•Vomiting (8-13%)

•Stomach pain (9-10%)

•Indigestion (9-10%)

Common Side Effects for

•Nausea (33%)

•Constipation (19%)

•Headache (18%)

•Vomiting (11%)

•Dizziness (10%)

•Trouble sleeping (9%)

•Dry mouth (8%)

•Diarrhea (7%)
Warnings of Zepbound vs. Contrave
Common Side Effects for

•Risk of thyroid cancer

•Stomach problems

•Kidney damage

•Gallbladder problems

•Inflammation of the pancreas (pancreatitis)

•Allergic reactions

•Low blood sugar (hypoglycemia)

•Eye problems in people with Type 2 diabetes (diabetic retinopathy)

•Possible risk of suicidal thoughts and behavior

•Lung problems during general anesthesia or deep sedation

Common Side Effects for

•Risk of suicidal thoughts and behavior

•Possible changes in thoughts, behavior, and mood

•Seizures

•Don't take Contrave with opioid medications

•Higher blood pressure and faster heart rate

•Liver problems

•Mania (extreme enthusiasm or excitement)

•Worsening of glaucoma in certain people

•Potential risk of low blood sugar in people taking certain medications for Type 2 diabetes
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Key takeaways

Summary of Zepbound vs. Contrave

Indications of Zepbound vs. Contrave

Pros and Cons of Zepbound vs. Contrave

Common Side Effects of Zepbound vs. Contrave

Warnings of Zepbound vs. Contrave

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